Choosing not to Vaccinate? Your Doctor Could Fire You for That Choice

by Julie Snyder

A recent national survey of pediatricians found that around 25 percent, always, often or sometimes will turn a child away if the child's family refuses to vaccinate for basics such as polio and diphtheria.

You might have seen the recent headlines like, "Doctors 'fire' patients who refuse vaccines for their children: Ethical?" It appears to be a growing trend, but one that is not endorsed by any medical association.

The American Academy of Pediatrics guidelines state, "Pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child. The pediatrician may encourage the family to find another physician or practice."

More Families Asked to Leave Practices

As more physicians drop families who opt out of vaccines, there's a growing number of parents who are questioning immunization and certain vaccination schedules.

Parents choosing not to vaccinate do so for a number of reasons. They may be concerned over the number of immunizations given at a time or about the chemicals and other ingredients mixed in with the vaccines. Their child might have an allergy or health condition, making immunization an potential risk.

Those who don't vaccinate or selectively vaccinate frequently run into difficulty finding routine medical care.

In a 2011 study of Connecticut pediatricians 30 percent of 133 doctors said they had asked a family to leave their practice for vaccine refusal. A survey of 909 Midwestern pediatricians found that 21 percent reported discharging families for that reason.

By comparison, from 2001 to 2006, about 6 percent of physicians said they stopped working with families who refused vaccines and 16 percent said they sometimes dismissed them according to studies conducted by the AAP.

Why Doctors Turn Patients Away

"As patients have become savvier and more willing to challenge doctors, physicians have become increasingly reluctant to deal with uncooperative patients," said Arthur Caplan, a bioethics professor at the University of Pennsylvania.

At an ethics meeting held by Harvard Vanguard Medical Associates, Dr. Lisa Lehmann, director of the Center for Bioethics at Brigham and Women's Hospital offered theories as to why a doctor may turn a vaccine refusing family away. They include: 1) The possibility of eventual potential harm; 2) Safety of others; 3) Liability issues; and
4) "Herd: immunity -- when most get vaccinated, the community at large will develop a greater immunity.

Parents Share Opinions

"I think it depends on whether the family can receive adequate care elsewhere. If the pediatrician is only practice in town,he or she should accept the parent's decision and treat the child. If this family has thousands of potential healthcare providers, it's reasonable to encourage the family to find a pediatrician who supports their decision to not immunize," Jenn says.

"I think a doctor has a right to refuse unvaccinated children as patients. But if presented with a sick child, I think it's unethical to refuse to help," Mandy shares.

Gina says, "Some parents research and decide that the risks of some or all vaccinations outweigh the benefits. I can refuse a medication for myself if the disease holds less of a risk than the treatment. As the proxy for my minor child, I hold the same rights on her behalf."

"While I don't think it's ethical to refuse treatment to anyone, there should be a way to protect those of us who do vaccinate and may have babies too young to have received all their shots from those who choose not to vaccinate," Heather says.

If you and your doctor don't agree about vaccines, it is ethical for that doctor to refuse to treat your child?

Photo courtesy of iStockphoto.